Provider Demographics
NPI:1134625528
Name:CLIFFORD, MEGAN (LCSW-R)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 BONNIE BRAE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1801
Mailing Address - Country:US
Mailing Address - Phone:585-278-2231
Mailing Address - Fax:
Practice Address - Street 1:1296 E VICTOR RD
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9457
Practice Address - Country:US
Practice Address - Phone:585-433-5919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical